A community-centered intervention to improve infant feeding practices among Pakistani and Bangladeshi families living in the UK

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Breastfeeding is known to be the best way to feed an infant. Compared to bottle-fed babies, those who are breastfed for longer have a lower risk of serious infections, sudden infant death, and are less likely to become overweight as children. Breastfeeding longer also helps to reduce the risk of maternal cancers. The UK has one of the lowest rates of breastfeeding in the World, with less than 1% of mothers exclusively breastfeeding until 6 months as recommended by the World Health Organisation. Most programmes or extra support for breastfeeding are targeted at disadvantaged, white mothers, who are thought to be most in need of breastfeeding support, and much less attention has been paid to mothers from ethnic minorities who are thought to have relatively high rates of breastfeeding. Mothers of Indian, Pakistani and Bangladeshi origin are often grouped together as one 'South Asian' group when looking at breastfeeding rates (or other health behaviours), and when viewed this way it appears that their breastfeeding rates are relatively high. However, our recent research has separated these groups and has identified that infants from Pakistani and Bangladeshi communities are much less likely to be breastfed than infants from Indian communities. This means that families from the Pakistani and Bangladeshi communities have been left vulnerable to misinformation about breastfeeding and formula feeding and this could have significant consequences for the health of these communities. Research has shown that there are specific cultural beliefs and practices in these communities that may be harmful to successful initiation and maintenance of breastfeeding or might encourage early weaning. This means that a specific intervention is required which sensitively addresses the beliefs and practices unique to these communities. In order to successfully change practices that are considered social norms, an approach is required which engages the community and works with them to develop appropriate strategies. In this project we will employ a novel, community-based method to intervention development (the REPLACE approach) which has been developed to tackle female genital mutilation or other practices which are driven by social or cultural norms. We will host engagement events in the target communities and recruit six 'community research facilitators' who will help us to approach research participants and facilitate communication with them in a series of 13 workshops. Each workshop will address an area of interest to the research, discuss social norms and beliefs and discuss opportunities for behaviour change. We will present the outcomes of this research in three seminars for health and community practitioners and invite them to discuss their resource and training needs for working with the target communities. We will then develop a toolkit of resources (including key messages, images, infographics, and a user manual, available in several languages) that can be used by community and healthcare practitioners to enable them to offer culturally sensitive information and support.